| Grace Community Medical Center | |
|
3222 N 34th St Tampa FL 33605-2227 | |
| (813) 930-5642 | |
| (813) 374-4979 |
| Full Name | Grace Community Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3222 N 34th St, Tampa, Florida |
| Authorized Official Name and Position | Grace Glenn (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8139305642 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Community Medical Center Po Box 270114 Tampa FL 33688-0114 Ph: (813) 930-5642 | Grace Community Medical Center 3222 N 34th St Tampa FL 33605-2227 Ph: (813) 930-5642 |
| NPI Number | 1548836927 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 06/22/2021 |
| Medicare PECOS PAC ID | 0446637474 |
|---|---|
| Medicare Enrollment ID | O20220513000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548836927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Behnaz Parsamehr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245615731 PECOS PAC ID: 7810256856 Enrollment ID: I20181129002868 |
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